Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean
Objective We aimed to describe the typical clinical and laboratory features and treatment of children diagnosed with multisystem inflammatory syndrome in children (MIS-C) and to understand the differences as compared to severe/critical pediatric cases with COVID-19 in an eastern Mediterranean country. Methods Children (aged <18 years) who diagnosed with MIS-C and severe/critical pediatric cases with COVID-19 and were admitted to hospital between March 26 and November 3, 2020 were enrolled in the study. Results A total of 52 patients, 22 patients diagnosed with COVID-19 with severe/critical disease course and 30 patients diagnosed with MIS-C, were included in the study. Although severe COVID-19 cases and cases with MIS-C share many clinical and laboratory features, MIS-C cases had longer fever duration and higher rate of the existence of rash, conjunctival injection, peripheral edema, abdominal pain, altered mental status, and myalgia than in severe cases (p<0.001 for each). Of all, 53.3% of MIS-C cases had the evidence of myocardial involvement as compared to severe cases (27.2%). Additionally, C-reactive protein (CRP) and white blood cell (WBC) are the independent predictors for the diagnosis of MIS-C, particularly in the existence of conjunctival injection and rash. Corticosteroids, intravenous immunoglobulin (IVIG), and biologic immunomodulatory treatments were mainly used in MIS-C cases rather than cases with severe disease course. There were only three deaths among 52 patients, one of whom had Burkitt lymphoma and the two cases with severe COVID-19 of late referral. Conclusion Differences between clinical presentations, acute phase responses, organ involvements, and management strategies indicate that MIS-C might be a distinct immunopathogenic disease as compared to pediatric COVID-19. Conjunctival injection and higher CRP and low WBC count are reliable diagnostic parameters for MIS-C cases.Key Points• MIS-C cases had longer fever duration and higher rate of the existence of rash, conjunctival injection, peripheral edema, abdominal pain, altered mental status, and myalgia than in severe/critical pediatric cases with COVID-19.• Higher CRP and low total WBC count are the independent predictors for the diagnosis of MIS-C.• MIS-C might be a distinct immunopathogenic disease as compared to pediatric COVID-19..
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2021 |
---|---|
Erschienen: |
2021 |
Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
---|---|
Enthalten in: |
Clinical rheumatology - 40(2021), 8 vom: 12. Feb., Seite 3227-3237 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Ozsurekci, Yasemin [VerfasserIn] |
---|
Links: |
Volltext [lizenzpflichtig] |
---|
BKL: | |
---|---|
Themen: |
Hyperinflammation |
Anmerkungen: |
© International League of Associations for Rheumatology (ILAR) 2021. corrected publication 2021 |
---|
doi: |
10.1007/s10067-021-05631-9 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
SPR044592582 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | SPR044592582 | ||
003 | DE-627 | ||
005 | 20230519202640.0 | ||
007 | cr uuu---uuuuu | ||
008 | 210720s2021 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1007/s10067-021-05631-9 |2 doi | |
035 | |a (DE-627)SPR044592582 | ||
035 | |a (SPR)s10067-021-05631-9-e | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
082 | 0 | 4 | |a 610 |q ASE |
082 | 0 | 4 | |a 610 |q ASE |
084 | |a 44.00 |2 bkl | ||
084 | |a 44.83 |2 bkl | ||
100 | 1 | |a Ozsurekci, Yasemin |e verfasserin |4 aut | |
245 | 1 | 0 | |a Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean |
264 | 1 | |c 2021 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a Computermedien |b c |2 rdamedia | ||
338 | |a Online-Ressource |b cr |2 rdacarrier | ||
500 | |a © International League of Associations for Rheumatology (ILAR) 2021. corrected publication 2021 | ||
520 | |a Objective We aimed to describe the typical clinical and laboratory features and treatment of children diagnosed with multisystem inflammatory syndrome in children (MIS-C) and to understand the differences as compared to severe/critical pediatric cases with COVID-19 in an eastern Mediterranean country. Methods Children (aged <18 years) who diagnosed with MIS-C and severe/critical pediatric cases with COVID-19 and were admitted to hospital between March 26 and November 3, 2020 were enrolled in the study. Results A total of 52 patients, 22 patients diagnosed with COVID-19 with severe/critical disease course and 30 patients diagnosed with MIS-C, were included in the study. Although severe COVID-19 cases and cases with MIS-C share many clinical and laboratory features, MIS-C cases had longer fever duration and higher rate of the existence of rash, conjunctival injection, peripheral edema, abdominal pain, altered mental status, and myalgia than in severe cases (p<0.001 for each). Of all, 53.3% of MIS-C cases had the evidence of myocardial involvement as compared to severe cases (27.2%). Additionally, C-reactive protein (CRP) and white blood cell (WBC) are the independent predictors for the diagnosis of MIS-C, particularly in the existence of conjunctival injection and rash. Corticosteroids, intravenous immunoglobulin (IVIG), and biologic immunomodulatory treatments were mainly used in MIS-C cases rather than cases with severe disease course. There were only three deaths among 52 patients, one of whom had Burkitt lymphoma and the two cases with severe COVID-19 of late referral. Conclusion Differences between clinical presentations, acute phase responses, organ involvements, and management strategies indicate that MIS-C might be a distinct immunopathogenic disease as compared to pediatric COVID-19. Conjunctival injection and higher CRP and low WBC count are reliable diagnostic parameters for MIS-C cases.Key Points• MIS-C cases had longer fever duration and higher rate of the existence of rash, conjunctival injection, peripheral edema, abdominal pain, altered mental status, and myalgia than in severe/critical pediatric cases with COVID-19.• Higher CRP and low total WBC count are the independent predictors for the diagnosis of MIS-C.• MIS-C might be a distinct immunopathogenic disease as compared to pediatric COVID-19. | ||
650 | 4 | |a Kawasaki disease |7 (dpeaa)DE-He213 | |
650 | 4 | |a Pediatrics |7 (dpeaa)DE-He213 | |
650 | 4 | |a Hyperinflammation |7 (dpeaa)DE-He213 | |
650 | 4 | |a Multisystem inflammatory syndrome in children (MIS-C) |7 (dpeaa)DE-He213 | |
650 | 4 | |a Multisystem inflammatory syndrome in adults (MIS-A) |7 (dpeaa)DE-He213 | |
700 | 1 | |a Gürlevik, Sibel |e verfasserin |4 aut | |
700 | 1 | |a Kesici, Selman |e verfasserin |4 aut | |
700 | 1 | |a Akca, Ummusen Kaya |e verfasserin |4 aut | |
700 | 1 | |a Oygar, Pembe Derin |e verfasserin |4 aut | |
700 | 1 | |a Aykac, Kubra |e verfasserin |4 aut | |
700 | 1 | |a Karacanoglu, Dilek |e verfasserin |4 aut | |
700 | 1 | |a Sarıtas Nakip, Ozlem |e verfasserin |4 aut | |
700 | 1 | |a Ilbay, Sare |e verfasserin |4 aut | |
700 | 1 | |a Katlan, Ban |e verfasserin |4 aut | |
700 | 1 | |a Ertugrul, İlker |e verfasserin |4 aut | |
700 | 1 | |a Cengiz, Ali Bülent |e verfasserin |4 aut | |
700 | 1 | |a Basaran, Ozge |e verfasserin |4 aut | |
700 | 1 | |a Cura Yayla, Burcu Ceylan |e verfasserin |4 aut | |
700 | 1 | |a Karakaya, Jale |e verfasserin |4 aut | |
700 | 1 | |a Bilginer, Yelda |e verfasserin |4 aut | |
700 | 1 | |a Bayrakci, Benan |e verfasserin |4 aut | |
700 | 1 | |a Ceyhan, Mehmet |e verfasserin |4 aut | |
700 | 1 | |a Ozen, Seza |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Clinical rheumatology |d London : Springer, 1982 |g 40(2021), 8 vom: 12. Feb., Seite 3227-3237 |w (DE-627)SPR008480389 |w (DE-600)1480901-1 |x 1434-9949 |7 nnns |
773 | 1 | 8 | |g volume:40 |g year:2021 |g number:8 |g day:12 |g month:02 |g pages:3227-3237 |
856 | 4 | 0 | |u https://dx.doi.org/10.1007/s10067-021-05631-9 |z lizenzpflichtig |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_SPRINGER | ||
912 | |a SSG-OLC-PHA | ||
936 | b | k | |a 44.00 |q ASE |
936 | b | k | |a 44.83 |q ASE |
951 | |a AR | ||
952 | |d 40 |j 2021 |e 8 |b 12 |c 02 |h 3227-3237 |